More Articles

Many central Ohio physicians think that federal health-care reform will drastically change their
practices and harm health-care delivery, a survey has found. And the current climate and upcoming
changes are prompting many to consider retiring early.

The survey was done by
The Dispatch and WBNS-TV (Channel 10) with the assistance of the Ohio State Medical
Association. Central Ohio doctors were asked to respond to an online survey, and 78 did. The
results are not scientific but do provide some insight into what some physicians think about
health-care reform and other matters.

Of the physicians who responded, 37 (almost half) said that health-care reform will
"drastically" affect their practice, and 58 (74 percent) said health-care delivery will be
"somewhat worse" or "much worse."

Citing wide-ranging challenges that include lower incomes, government regulations, high stress
and decreasing happiness at work, three out of four doctors surveyed said they "sometimes" or
"often" consider retiring early.

Some responses mirrored those found two years ago when the Physicians' Foundation surveyed about
12,000 physicians nationwide and asked several of the same questions.

In both surveys, a majority of doctors:

• Find the practice of medicine "less satisfying."

• Think there are too few primary-care physicians.

• Say that patients who don't have urgent problems wait two to five days to see them.

Although leaving medicine is not the short-term plan for a majority of doctors here or
nationally, some say they will retire or move out of clinical practice in the next three years. In
the central Ohio survey, 11 said they'd retire, four said they'd look for a non-clinical job within
health care, and one planned to leave health care for another field.

Doctors' worries about the future of health care varied, but many said there already aren't
enough primary-care doctors and access to those who are around will be even more difficult as more
Americans are insured.

Participants could remain anonymous, but some shared their names.

Dr. Deborah Wilson, who practices in Marysville, said she is overworked, underpaid and already
burdened by rules and regulations that eat up time better spent with patients.

"I love being a family doctor, but the system drives me crazy," she said.

As specifics of reform are worked out, she worries about unnecessary hurdles, paperwork and
changes that don't realistically improve the care Americans receive.

"The devil is in the details, and that's the part of health-care reform that really worries me,"
Wilson said, adding that she is in favor of universal health care.

The nation is in urgent need of more primary-care doctors, a problem that will be fixed only if
pay goes up, she said.

"I spend a half an hour counseling a person on their diabetes, their hypertension and their
cholesterol, and I hope I get $75, maybe $100," she said. "A gastroenterologist spends 30 minutes
doing a colonoscopy and gets two to three times what I get."

Dr. William Cotton, who is medical director of the primary-care network at Nationwide Children's
Hospital, said he favors giving more people access to health care, but "handing them a valid
insurance card doesn't mean there are people to take care of them."

Many doctors limit the number of Medicaid patients they take on because of low reimbursement. In
the central Ohio survey, half said they don't accept Medicaid patients or they limit the number
they care for; about a third don't accept Medicare patients or limit their number.

"Medicaid pays 65 percent of what it costs to see the patient," said Cotton, who is also
immediate past president of the Ohio chapter of the American Academy of Pediatrics.

The primary-care doctor shortage won't be resolved until more young people go into the field,
and it could get worse if lots of doctors retire early, many doctors in the survey said.

Dr. Rod Comisar, an orthopedic surgeon in Columbus, said he sometimes thinks of early retirement
because the operational side of medicine is getting increasingly difficult. Costs are going up "at
a time when there is less overall respect and appreciation for the profession," he wrote.

Although their numbers were smaller, other doctors said they're happy with their careers, and
they applauded health-care reform.

"I think it's a tragedy that in our country - the wealthiest in the world - we can't guarantee
some basic health care for all of our citizens. It's a tragedy that hard-working people who've paid
their bills all their lives, if they get seriously ill, may go bankrupt and lose their homes," said
Dr. John Tyznik.

"I think the reform process will be very painful and very disruptive, but I think we need
it."

Tyznik, a family doctor in Gahanna who has been practicing for almost 30 years, said he loves
his job and never considers retiring even in the face of increasing regulations and paperwork.

He does not accept new Medicaid patients because of the financial drain on his practice, he
said, and reimbursement must increase to solve the problem of low-income people who are struggling
to find a primary-care physician.

"We feel very badly about it," he said, "but we in family medicine simply want to make enough
money to keep the practice open."